What Happens to the Pocket After Breast Implant Removal?

Typically, I recommend removal of the capsule along with removal of the implant in order to prevent long-term fluid collection within this space.  Inevitably, there is some capsule formation in this breast pocket created with and around the implant.  In order to get the tissue to re-adhere and obliterate the potential space from where the pocket was previously, removal of the capsule (i.e., capsulectomy) is advised along with placement of a drain.  Once done, your breast should have the same appearance and feel and you should not be able to feel any difference.  Hope that these answers help!

If you don't have a thickened capsule (capsular contracture) or calcification of the capsule, it is likely that you will not feel or notice the capsules after implant removal. Over time the capsules should shrink and scar down. However, in some circumstances it is advisable to remove the capsules (capsulectomy) which will allow the tissues to heal and the pockets to go away completely. It would be best to discuss this with your plastic surgeon to determine the best plan for you. 

Following explant, the pocket collapses and shrinks but to a certain extent remains. It is usually not palpable or visible (this is a function of the overlying native breast, skin and fat). For most, this will not be an issue, however it can in some cases accumulate fluid.If excised, the space will scar down. There is no consensus on whether it should always be removed and is often decided on a case by case basis. Typically a partial capsular removal is undertaken at the time of explant to facilitate healing, however, a total capsulectomy is a greater undertaking as both the anterior and posterior aspects of the capsule need to be peeled off of the adherent tissues.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

The breast capsule around a prosthesis is a normal body reaction. When the prosthesis is removed, the capsule can be sutured to the deeper tissue to "close" the space. If the capsule is very thick (as in someone who many have capsular contracture), then I would do a capsulectomy to remove all the capsule and then suture the tissue to "close" this space.
I would definitely use drains postop to decrease seroma formation. Also, the breast may need to be reshaped/tightened if there is laxity in the breast skin (mastopexy/lift). 

Hi! There are 2 options for explantation, implant removal while leaving the capsule or capsulectomy. The former lets microscopic amounts of gel to remain in the capsule and the latter will enable the surgeon to remove as much silicone as reasonable without creating significant deformity. However, this operation may require a larger incision and both surgery and recovery time will be longer. Technically, there will be excess skin from when your breast accommodated the size of the implants. So yes, the breasts will be smaller and sag after explantation. However, the shape and size of the breast will be unpredictable. It still varies greatly between patients because age, genetics, environment, skin elasticity, etc. will affect the results.There are other options such as breast lift, California Lift or natural breast augmentation (performed with fat grafting) if you are not satisfied with the result after explantation. It is best to consult your surgeon regarding this concern. #RealSelf100

These are great questions. If the scar tissue pocket is not removed (capsulectomy) when the implant is removed there is a smooth capsule of scar tissue left which has the propensity to fill with the natural fluid your body can make. This can potentially lead to a persistent fluid collection (seroma) or even an infection. For this reason I favor removing the scar tissue capsule when breast implants are removed. 

When implants are removed without plans for replacement, the thin layer of scar tissue surrounding the implant (the capsule) is typically removed as well, allowing your tissues to heal together and obliterating this space.  This process often requires placement of a drain to prevent your body from filling this potential space with fluid immediately following surgery.  The drain is usually removed within a week of surgery.  It would be very unusual to feel any capsule remnants.

If a capsulectomy is not performed, the implant pocket will remain.  You should not feel it unless the capsule is thickened.

                  In
the vast majority of explantation cases, it’s not necessary to remove the
capsule that surrounds the breast implant.  When these capsules are left alone they collapse upon
themselves and the implant pocket is eventually obliterated.  In addition, capsule removal may be
associated with secondary complications such as bleeding.  For this reason, removal of breast
capsules isn’t undertaken without specific indications.

                  When
patients have ruptured silicone implants, calcified capsules or thickened
capsules with breast distortion, capsulectomy is usually indicated.  Under these circumstances failure to
remove the capsule will result in a persistent deformity.

The answer depends on whether you have capsular contracture.  If you have severe contractures, it is best to remove them capsules as well as the implants, so you don't develop a mass from the left over capsules.  If your breasts are soft, however, a simple removal would be fine and the capsules left behind with no problems.